Enlightenment of Efficiency Frontier Approach on the Methods of Pharmacoeconomic Evaluation in China / 中国药房

ABSTRACT

OBJECTIVE：To p rovide reference for pharmacoecono mic study in China. METHODS ：The key steps in the operation process of efficiency frontier approach （EFA）were analyzed ；the similarities and differences of EFA with cost-utility analysis（CUA）and cost-effectiveness analysis （CEA）were compared on the basis of case demonstration ；the enlightenment of EFA to pharmacoeconomic evaluation and related decision-making in China were puts forward combined with the practice of China. RESULTS & CONCLUSIONS ：The research framework of EFA could be roughly divided into 5 parts：cost calculation ，benefit definition，model establishment ，incremental analysis and sensitivity analysis. Benefit indicators were the measurement indicators of health output in EFA ，including clinical indicators and comprehensive indicators ，among which comprehensive indicators were more widely used. When constructing the efficiency frontier ，the benefit of the intervention measures was generally taken as the ordinate and the cost of the intervention measures as the abscissa. The cost-benefit coordinate points of each alternative intervention measure in a specific disease field constituted the cost-benefit plane frontier. Researchers conducted economic evaluation by judging the relative position between each alternative intervention measure and the efficiency frontier. Thewillingness to pay threshold was numerically equal to the reciprocal of the ray slope outside the efficiency frontier. Generally speaking ，EFA was similar to CUA and CEA. All of them needed to clarify the cost and health output ，model analysis ， data source and uncertainty analysis ；however，EFA was different from CUA and CEA in intervention measures and control selection，expression form of evaluation results ，willingness to pay threshold ，etc. It is suggested that the payers in China can consider using EFA to calculate the willingness to pay threshold of specific disease areas to ensure the accessibility of some drugs in short supply ；establish a health insurance database of specific diseases to standardize the data quality and form a clear evaluation standard at the same time ，or combine a variety of pharmacoeconomic evaluation methods to enrich the application materials so as to ensure both clinical value and economy of the intervention measure.